Oral Health and Behavioral Health Disorders

A strong interaction exists between oral health and behavioral health. Stress can contribute to dry mouth, tooth grinding, TMJ, gum disease, and mouth sores. Some of the most common behavioral health problems affecting oral health are: mood disorders, depression, anxiety, panic attacks, eating disorders, substance-use disorders including smoking, obsessive-compulsive disorder, self-harm, and schizophrenia. These behavioral health issues are often associated with changes in mood, cognition, and/or motivation that affect self-care behaviors like oral hygiene, increasing risk for tooth decay. Side effects of psychotropic medications can cause gingivitis, xerostomia (dry mouth), and metabolic syndrome, which can increase risk for periodontal disease and caries. Lack of access to dental treatment due to lack of insurance or financial issues are common in those with behavioral health problems.

Many veterans have lingering behavioral health issues. The most common are post-traumatic stress disorder (PTSD), depression, and traumatic brain injury (TBI). Oral health is not an essential benefit of VA health care.

“Many veterans do not qualify for dental care from Veterans Affairs unless they have a preexisting dental condition, a disability, or were a prisoner of war…In many states, Medicaid does not cover adult dental health, and Medicare provides no dental benefits” (Silk, 2020). Veterans with anxiety disorders, depression, PTSD, smoking, or drug and/or alcohol use may be at high risk of developing poor oral health. Given the lack of access to an oral health benefit and care, promoting oral hygiene self-care behaviors becomes essential.

This teaching strategy will increase students’ awareness of the link between oral health and behavioral health. It will provide interventions to assist the student to help patients understand the importance of oral health to overall health and to increase oral health self-care behaviors in patients with mental health problems.